DECREASE IN HOSPITALIZATION FOR TREATMENT OF CHILDHOOD ASTHMA WITH INCREASED USE OF ANTIINFLAMMATORY TREATMENT, DESPITE AN INCREASE IN THE PREVALENCE OF ASTHMA

Background: During the past 15 years, the prevalence of asthma in chil dren in Sweeden has doubled. However, since, 1985, antiyinflammatory t reatment with inhaled steroids has increased continuously. Objective: The aim of this study was to analyze the net effect of these changes i n terms of hospitalization of children for treatment of asthma. Method s: The numbers of hospital days, admissions, and individual patients a dmitted to the Children's Hospital in Goteborg because of acute asthma were recorded from 1985 through 1993. All the in-patient treatment of children is centralized at this hospital (i.e., the study was populat ion-based). Goteborg has half a million inhabitants. Hospitalization p olicies were not altered during the study period. Results: In children aged 2 to 18 years, the number of hospital days per year gradually de creased to less than a third (r = 0.9; p < 0.001), and admissions decr eased by 45% (r = 0.7; p < 0.05). The decrease in hospitalization was most marked in the group older than the age of 5 years in which hospit al days were reduced to one fifth (r = 0.9; p < 0.0001) and admissions were halved (r = 0.8; p < 0.05). A decreasing trend in number of hosp ital days was also seen in the 2- to 5-year-old group. The number of i ndividual patients admitted did not show a statistically significant d ecreasing trend. In children under the age of 2 years, the number of h ospital days fluctuated, and there was no clear-cut change with time. Conclusion: Although increased concentration on the education of paten ts and patients may have been a contributing factor, the major reason for the decrease in hospitalization in the group of children aged 2 to 18 years is most probably antiinflammatory treatment with inhaled ste roids. The results suggest that this is a very cost-effective therapeu tic approach.